Lung cancer is often thought of as a disease that impacts older adults with a long history of smoking, but today, that picture is changing. Up to 20 percent of new lung cancer cases now occur in people who have never smoked, and many of them are women under 50. While smoking remains the leading cause, experts say other factors are driving this shift. “We’re seeing a change in trends,” says Gerald Colvin, DO, of South County Health Cancer Center. “Younger patients and nonsmokers are showing up with lung cancer more than ever before. Environmental factors like radon, air pollution, and genetics are key contributors.”
Radon, a naturally occurring, colorless, odorless radioactive gas, is one of the most significant risks. It can enter homes through cracks or foundations and build up without any warning. “People can be exposed at a young age and not develop tumors until decades later.” Dr. Colvin explains. In fact, one in three houses in Rhode Island have too much radon; in the towns of Richmond and Exeter, this jumps to one in two. This is because, in addition to erosion and tectonic uplift, a glacier during the Ice Age stripped much of the land in Rhode Island and the remaining dirt is quite close to bedrock, which contains granite. Within granite, both uranium and radon, a natural by-product of uranium decay, are found. Dr. Colvin believes every home in Rhode Island should be tested for radon. Primary prevention of lung cancer by mitigating excess radon is key.
Because symptoms of lung cancer can be subtle or easily mistaken for something else, early detection matters. Stage 1 lung cancer is often treatable with surgery alone, giving patients the best chance for a full recovery. “At stage 1, lung cancer can be removed surgically, or treated with stereotactic radiosurgery and never requires use of regular chemotherapy; sometimes post-treatment EGFR (epidermal growth factor receptor) inhibitors are used depending on the tumor biology,” says Dr. Colvin. “But catching it early is key.”
Unfortunately, this kind of early detection only happens around 15 percent of the time. Anyone who has smoked an average of 20 pack years (a pack a day for 20 years), and is between the age of 50-80 and an active smoker or quit within the last 15 years, should have an annual low-dose CT (computed tomography) scan of the chest. Once lung cancer starts to develop, it could take one to two years before symptoms develop. Women who have a history of smoking are more sensitive to development of lung cancer compared with men who smoked the same amount. In addition, the incidence of lung cancer in never-smokers is higher in women (20-25 percent) compared with men (five-10 percent). Researchers do not know why this is the case.
“Even if you don’t smoke, these signs shouldn’t be ignored,” Dr. Colvin emphasizes. “Early attention saves lives.”
Medical Director, Cancer Center South County Health
100 Kenyon Avenue, Wakefield
401-782-8000
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